What is vaginal bleeding?

Vaginal bleeding usually means there is blood coming from your uterus (womb) or cervix (lower part of your uterus).

Read more on the female reproductive system.

What causes vaginal bleeding?

There are many reasons why you may bleed from your vagina. Some causes are normal and to be expected. Other causes may be abnormal and a sign of a problem.

Period (menstrual) bleeding

Most females experience vaginal bleeding every month during their period (also called menstruation). This happens between puberty and menopause and is a normal part of the menstrual cycle and usually lasts 5 to 7 days.

What is 'normal' vaginal bleeding can be different for everyone. It can also change at different times in your life, such as during:

• puberty
• pregnancy
• menopause

Some people may have:

• irregular periods — when your period doesn’t come at the same time each month
• heavy periods — when you bleed more than usual or for longer than usual

Bleeding between your periods or after sex

Vaginal bleeding can also happen between your periods — this is called intermenstrual bleeding. This sometimes happens after sex.

Vaginal bleeding between your periods and after sex may be caused by:

• polyps or fibroids in the uterus
• pelvic inflammatory disease (PID) caused by sexually transmitted infections (STIs) — such as chlamydia, gonorrhoea and human papilloma virus (HPV)
• cervical cancer, endometrial cancer or pre-cancerous conditions
• injury or trauma
• blood clotting problems
• the start of perimenopause

Bleeding during pregnancy

You can also experience vaginal bleeding during pregnancy. This may happen for different reasons, such as an ectopic pregnancy or a threatened miscarriage.

Medicines

Some medicines can also cause vaginal bleeding, such as:

• hormonal contraception
• menopausal hormone therapy (MHT), also known as hormone replacement therapy (HRT)
• blood thinners

What symptoms are related to vaginal bleeding?

Your symptoms depend on whether your bleeding is part of your normal period or caused by something else.

Symptoms that may happen with vaginal bleeding include:

• pelvic pain, tummy pain and lower back pain
• pain during sex
• unusual vaginal discharge
• passing blood clots
• feeling dizzy, lightheaded and tired
• nausea and vomiting

How is the cause of vaginal bleeding diagnosed?

To find out what’s causing your vaginal bleeding, your doctor may suggest tests. The tests will depend on your age and symptoms. You may be referred to a specialist doctor, called a gynaecologist.

Your doctor may:

• ask questions about your health, when and how often the bleeding happens
• do a vaginal examination
• test for STIs, such as HPV, chlamydia and gonorrhoea
• do a blood test
• refer you for imaging tests, such as a vaginal ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI) scan or hysteroscopy
• take a sample (biopsy) of the lining of your womb (endometrium)

Your doctor should always check for cervical cancer if you have ongoing or abnormal vaginal bleeding.

If you are diagnosed with chlamydia or gonorrhoea, your doctor must let the Department of Health know. This is because they are nationally notifiable diseases. This helps to monitor and track chlamydia and gonorrhoea infection outbreaks and improve healthcare responses.

When should I see my doctor?

You should see your doctor if you have vaginal bleeding:

• between your periods
• after sex (regardless of your age)
• after you’ve been through menopause
• and you think you might be pregnant

You should also see your doctor if:

• your periods are heavy
• you feel sick, dizzy or unwell during your period
• you have an unusual discharge from your vagina during your period
• you have a fever or pain with your period

What should I do if I feel I am not being heard?

If you are worried about your bleeding and feel your doctor isn’t taking you seriously, it’s OK to speak up. You know your body best and you deserve to be heard. Here are some things you can do:

• Write down your symptoms before your appointment. This can help you remember what to say during your appointment.
• Bring a trusted friend with you who can support you and speak up for you if needed.
• If you’re still worried, you have the right to see a different doctor for a second opinion.

How is vaginal bleeding treated?

Treatment depends on the cause of bleeding and your symptoms. Your doctor may refer you to a gynaecologist.

Read more on the role of a gynaecologist.

Self-care at home

Here are some things you can do at home to help manage vaginal bleeding:

• Keep track of your bleeding to share with your doctor.
• Use pads or tampons that feel comfortable to you.
• Rest when you feel tired.
• Join a support group or social media platform to talk with others going through the same thing.
• Eat healthily and stay active to support your body.
• Use a heat pack to ease any pain.

Medicines for vaginal bleeding

Depending on the cause, your doctor may prescribe medicines, such as:

• hormone medicines
• intravenous (IV) iron infusion
• anti-inflammatory medicine (NSAIDs)
• medicine that helps your blood to clot
• antibiotics or antiviral medicines

Other treatment options

A special procedure called thermal balloon endometrial ablation may be done to stop any bleeding.

Your health team may recommend surgery to remove the uterus (hysterectomy) if:

• your vaginal bleeding is caused by perimenopause
• bleeding is affecting your quality of life
• other treatments have not worked
• you aren’t pregnant
• you’re not planning to become pregnant in the future

If your vaginal bleeding is caused by cancer, your doctors will discuss your treatment options with you.

What are the complications of vaginal bleeding?

If you bleed a lot over time, it can lead to anaemia.

Vaginal bleeding may also affect your quality of life.

Can vaginal bleeding be prevented?

You can’t always prevent vaginal bleeding. You can lower your chance of some causes — for example, practising safe sex can help protect you from sexually transmitted infections (STIs).

Resources and support

• Read more about vaginal bleeding on the Queensland Government website.
• The Royal Women’s Hospital has a fact sheet about bleeding after menopause.
• RANZCOG offers information about heavy menstrual bleeding.

You can call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

• Jean Hailes for Women’s Health has fact sheets translated into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

• Watch the video ‘Yarning about Aboriginal Women’s Health Business’ from The Department of Health, Disability and Ageing.
• Our Mob and Cancer has information about cervical cancer for Aboriginal and/or Torres Strait Islander People.

Easy-read resources

• Sexual Health Victoria offers fact sheets about sexual health written in plain English.